AHA PALS EXAM 2024 ACTUAL EXAM 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES, Exams of Nursing

Download AHA PALS EXAM 2024 ACTUAL EXAM 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES and more Exams Nursing in PDF only on Docsity! 1 | P a g e AHA PALS EXAM 2024 ACTUAL EXAM 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ NEWEST VERSION 1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis of this information, which of the following provides the best interpretation of the oxygen saturation of 95% by pulse oximetry? A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be administered 2 | P a g e C. Unreliable; no supplementary oxygen is indicated D. Unreliable; supplementary oxygen should be administered 2. A 3-year-old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the child's most likely condition? A. Septic shock B. Hypovolemic shock C. Significant bradycardia D. Cardiogenic shock 5 | P a g e 7. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal? A. Vascular resistance B. Pulse rate C. Lung compliance D. Control of breathing 8. What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A. Decreased oxygen saturation B. Stridor C. Normal respiratory rate D. Decreased respiratory effort 6 | P a g e 9. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient's condition? A. Respiratory distress B. Respiratory arrest C. Respiratory failure D. Disordered control of breathing 10. The parents of a 7-year-old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most appropriate intervention? 7 | P a g e A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with an oncologist to determine the chemotherapeutic regimen 11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular access? A. Two providers may attempt peripheral vascular access twice each B. Three providers may attempt peripheral vascular access once each C. Place a central venous line 10 | P a g e 15. A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention? A. Obtain a chest x-ray B. Perform needle decompression on the left chest C. Insert a chest tube on the left side D. Insert an IV and administer 20 mL/kg of normal saline 16. A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition? A. Hypotensive shock 11 | P a g e B. Compensated shock C. No longer in shock D. Cardiogenic shock 17. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention? A. Provide synchronized cardioversion at 0.5 to 1 J/kg B. Attempt vagal maneuvers C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg over 20 minutes 18. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive 12 | P a g e and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child? A. 92% to 100% B. 92% to 99% C. 94% to 99% D. 94% to 100% 19. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway secretions. The infant's heart rate decreases from 155/min to 65/min as shown below. The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second. What is the most appropriate initial intervention? A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate does not increase B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV 15 | P a g e 23. A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention? A. Give atropine 0.02 mg/kg lIO/IV B. Apply cricoid pressure C. Give epinephrine 0.01 mg/kg IO/IV D. Provide transthoracic pacing 24. A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention? A. Attempt defibrillation with a 2 J/kg shock B. Administer epinephrine 0.01 mg/kg C. Consider placement of an advanced airway D. Administer amiodarone 5 mg/kg 16 | P a g e 25. A pulseless 6-week-old infant arrives in the emergency department, and high-quality CPR is in progress. The initial rhythm strip is shown below. CPR continues, and vascular access has been established. What is the next appropriate intervention? A. Administer atropine 0.02 mg/kg IO/IV B. Attempt defibrillation with a 2 J/kg shock C. Administer epinephrine 0.01 mg/kg IO/IV D. Consider insertion of an advanced airway 26. A 6-month-old infant is unresponsive and not breathing. What is the maximum time that should be spent trying to palpate the pulse before starting CPR? A. 10 seconds B. 15 seconds C. 30 seconds D. 60 seconds 17 | P a g e 27. What is the recommended location to check for a pulse in a 3- month-old infant? A. Carotid B. Radial C. Brachial D. Cardiac apex 28. A 7-year-old child presents in pulseless arrest. The child's ECG shows the rhythm below. Which of the following describes the patient's condition? A. Ventricular escape rhythm B. Ventricular tachycardia C. Pulseless electrical activity D. Sinus bradycardia 30. A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is 20 | P a g e C. Reassess breath sounds and clinical status D. Repeat the albuterol treatment 2. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate? A. Respiratory distress is unchanged B. Progression toward respiratory failure C. Improved respiratory status D. Neurologic impairment 3. What is the most likely cause of head bobbing in infants? A. Increased respiratory effort B. Improving respiratory status C. Decompensated shock D. Brain injury 21 | P a g e 4. Several healthcare providers are participating in an attempted resuscitation. Which of the following is most consistent with the responsibilities of the team leader of the resuscitation? A. Records medications and interventions B. Assigns roles to team members C. Administers defibrillation shocks D. Provides compressions 5. Which of the following conditions is appropriate for use of an oropharyngeal airway? A. Conscious with no gag reflex B. Unconscious with a gag reflex C. Unconscious with no gag reflex D. Conscious with a gag reflex 22 | P a g e 7. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV D. Methylprednisolone IV 8. A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the most appropriate intervention for this child? A. Fluid bolus of 10 mL/kg of isotonic crystalloid B. Fluid bolus of 20 mL/kg of isotonic crystalloid 25 | P a g e pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill. Which term best describes this child's physiologic state? A. Compensated shock B. Cardiogenic shock C. Hypotensive shock D. Obstructive shock 13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next intervention for this child? A. Administer another 20 mL/kg normal saline fluid bolus B. Administer 10 mL/kg of packed red cells 26 | P a g e C. Continue to monitor and reevaluate the child D. Initiate a dopamine drip of 20 mcg/kg per minute 14. A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the following is the most appropriate initial intervention? A. Provide 100% oxygen via a nonrebreathing mask B. Obtain IV access C. Administer dopamine D. Administer an antibiotic 16. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? A. Obtain a chest radiograph 27 | P a g e B. Administer nebulized epinephrine C. Prepare for a surgical airway D. Use an epinephrine autoinjector 17. The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention? A. Give adenosine 0.1 mg/kg rapid IV push B. Perform carotid sinus massage C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg 18. An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The 30 | P a g e B. Synchronized cardioversion with 0.5 to 1 J/kg C. Epinephrine 0.01 mg/kg 10/IV D. Amiodarone 5 mg/kg 1O/IV 22. A 2-year-old child is in pulseless arrest. The child has received high-quality CPR, 2 shocks, and a dose of IV epinephrine. The next rhythm check reveals the rhythm shown below. What would be an appropriate energy dose for the third defibrillation attempt? A. 2 J/kg B. 2 to 4 J/kg C. 4 J/kg or greater D. Greater than 10 J/kg 23. A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention? 31 | P a g e A. Contact the child's family B. Provide CPR for 2 minutes C. Drive the child to the hospital D. Use the AED 24. A 3-year-old child is in cardiac arrest, and high- quality CPR is in progress. The first rhythm check reveals the rhythm below. Defibrillation is attempted with a shock dose of 2 J/kg. After administration of the shock, what is the most appropriate next intervention? A. Resume CPR, beginning with chest compressions B. Check for a pulse C. Analyze the rhythm D. Administer epinephrine 25. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation B. Hypotension 32 | P a g e C. An increase in serum pH (alkalosis) D. Abnormal respiratory sounds 26. A 3-year-old child is in cardiac arrest, and a resuscitation attempt is in progress. The child is in ventricular fibrillation and was given a shock at 2 J/kg, followed by immediate CPR. At the next rhythm check, ventricular fibrillation is again noted on the cardiac monitor. What is the most appropriate next intervention? A. Attempt defibrillation with a 4 J/kg shock B. Attempt defibrillation with a 2 J/kg shock C. Resume CPR D. Check for a pulse for at least 10 seconds 27. CPR is in progress on a 10-month-old infant who was unresponsive and not breathing, with no palpable pulse. A cardiac monitor is applied, and sinus bradycardia at a rate of 42/min is noted. CPR is resumed, and vascular 35 | P a g e 31. A team is attempting to resuscitate a child who was brought to the emergency department by EMS after a traumatic injury. The family members arrive at the child's bedside and request to remain in the room during the resuscitation attempt. What does the American Heart Association recommend? A. Allow the family to stay at the bedside alone, but they should not talk to anyone B. Allow the family to stay at the bedside with a staff member who is assigned to provide information and assistance C. Escort the family to an assigned family room where they can be given regular updates D. Take the family to the chapel or an assigned quiet room so they can receive expert consultation. 32. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? 36 | P a g e A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction D. Upper airway obstruction 33. A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. Which of the following is the next appropriate intervention? A. Rescue breaths at a rate of 12 to 20/min B. Rescue breaths at a rate of 6 to 10/min C. Chest compressions at a rate of at least 100/min D. Chest compressions at a rate of 60/min